体外受精-胚胎移植中冻融胚胎移植与新鲜胚胎移植临床妊娠结局比较  

Effect of frozen-thawed embryo transfer or fresh embryo transfer during vitro fertilization and embryo transfer on clinical pregnancy rate and outcomes

作　　者：习艳霞[1] 王慧春[1] 刘慧文[1] XI Yanxia;WANG Huichun;LIU Huiwen(Haidian Maternal and Child Health Care Hospital, Beijing, 100088)

机构地区：[1]北京市海淀区妇幼保健院,100088

出　　处：《中国计划生育学杂志》2021年第12期2593-2597,共5页Chinese Journal of Family Planning

摘　　要：目的:探究冻融胚胎移植(FET)与新鲜胚胎移植对体外受精-胚胎移植临床妊娠结局影响。方法:回顾性分析2019年1月-2019年12月本院行体外受精-胚胎移植患者473例临床资料,根据胚胎移植方案不同分为鲜胚胎组(n=327)与冻融胚胎组(n=146),对比两组临床基础资料及妊娠情况。采用多因素logistic回归分析影响FET患者临床妊娠的危险因素。结果:冻融胚胎组促性腺激素(Gn)总量少于鲜胚胎组,人绒毛膜促性腺激素(hCG)日雌二醇(E_(2))水平、孕酮(P)水平、受精率、临床妊娠率、巨大儿发生率均高于鲜胚胎组,卵巢过度刺激综合征(OHSS)发生率低于鲜胚胎组,hCG日子宫内膜厚度及获卵总数大于鲜胚胎组(均P<0.05)。冻融胚胎组妊娠成功患者Gn总量少于妊娠失败患者,hCG日E_(2)水平、P水平及受精率高于妊娠失败患者,hCG日子宫内膜厚度及获卵总数大于妊娠失败患者(均P<0.05)。hCG日E_(2)、P水平及子宫内膜厚度减小是影响FET临床妊娠的危险因素(P<0.05)。结论:体外受精-胚胎移植FET可降低OHSS发生率,且能获得更高的临床妊娠率及更好的妊娠结局,但巨大儿发生率增加。Objective:To explore the effect of frozen-thawed embryo transfer(FET)or fresh embryo transfer for treating women on their clinical pregnancy rate and pregnancy outcomes during vitro fertilization and embryo transfer(IVF-ET).Methods:The clinical data of 473 women who accepted IVF-ET from January 2019-December 2019 were analyzed retrospectively.These women were divided into group A(327women with fresh embryo transfer)and group B(146 women with FET)according to different embryo transfer schemes.The basic data and pregnant situation of the women were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors affecting the clinical pregnancy of the women with FET.Results:The total amount of gonadotropin(Gn)used of the women in group B was significantly less than that of the women in group A,the levels of estradiol(E_(2))and progesterone(P)on the human chorionic gonadotropin(hCG)day,the fertilization rate,the clinical pregnancy rate,and the incidence of macrosomia of the women in group B were significantly higher than those of the women in group A,but the incidence of ovarian hyperstimulation syndrome(OHSS),the endometrial thickness on the hCG day,and the total number of eggs obtained of the women in group B were significantly lower than those of the women in group A(all P<0.05).In group B,the total dosage of Gn used of the women with successful pregnancy was significantly less than that of the women with pregnancy failure,the levels of E_(2) and P on the hCG day,the fertilization rate,the endometrial thickness on the hCG day,and the total number of eggs obtained of the women with successful pregnancy were significantly higher than those of the women with pregnancy failure(all P<0.05).The levels of E_(2) and P,and the endometrial thickness thinned on the hCG day were the risk factors of clinical pregnancy of the women with FET(P<0.05).Conclusion:FET for treating women during IVF-ET can reduce the incidence of OHSS,and can obtain higher clinical pregnancy rate with better pregn

关 键 词：体外受精-胚胎移植 冻融胚胎移植 新鲜胚胎移植 妊娠率 妊娠结局 巨大儿 

分 类 号：R714.8[医药卫生—妇产科学]